Prevalence and characteristics of antibiotic prescription for acute COVID-19 patients in Japan

Abstract

COVID-19 is a viral infection and does not require antibiotics. The study aimed to elucidate a prescribing pattern of antibiotics for COVID-19. A nationwide cross-sectional study was conducted in Japan. The Diagnosis and Procedure Combinations (DPC) data was used to collect information, covering 25% of all acute care hospitals in the country. In 140,439 COVID-19 patients, 18,550 (13.21%) patients received antibiotics. Antibiotics were prescribed more often in inpatients (10,809 out of 66,912, 16.15%) than outpatients (7741 out of 73,527, 10.53%) (p < 0.001). Outpatient prescription was significantly associated with older patients (odds ratio [OR], 4.66; 95% confidence interval [CI] 4.41–4.93) and a greater Charlson index (OR with one-point index increase, 1.22; 95% CI 1.21–1.23). Inpatient prescription was significantly associated with older patients (OR 2.10; 95% CI 2.01–2.21), male gender (OR 1.12, 95% CI 1.07–1.18), a greater Charlson index (OR with one-point increase, 1.06; 95% CI 1.05–1.07), requirement of oxygen therapy (OR 3.44; 95% CI 3.28–3.60) and mechanical ventilation (OR 15.09; 95% CI 13.60–16.74). The most frequently prescribed antibiotic among outpatients was cefazolin, while that among inpatients was ceftriaxone. Antibiotic prescription is relatively low for acute COVID-19 in Japan. Antibiotic prescription was associated with older age, multi-morbidity, severe disease, and winter season.

Antibiotic usage patterns in COVID-19 patients in five tertiary hospitals from Bangladesh: A countrywide picture

“…According to our study findings, 94.4% of patients received antibiotics irrespective of disease severity, and 90.6% of patients received at least one antibiotic despite presenting with non-severe disease manifestations, which is a higher percentage than that previously reported (78%) in non-COVID patients [ 18 ]. However, the rate of antibiotic use in our study was lower than that observed in a study conducted in another center in Dhaka (100%) [ 6 ], but higher than those reported in other Asian countries such as Pakistan (89.7%) and Japan (13.21%) [ 19 , 20 ]. Global surveys conducted worldwide have concluded that increased use of antibiotics has been reported in more than half of the countries, with higher prevalence in LMICs [ 21 , 22 ].…”

Prevalence of Antibiotic Use in Hospitalized COVID-19 Patients: An Observational Study in Secondary Healthcare Hospitals in Kosovo

“…The same study reported that the antibiotics were prescribed to 16.15% hospitalized COVID-19 patients with lifethreatening and only 10.53%.for outpatients. 9 A study conducted in Hong Kong, only 29.1% of cases were treated with antibiotics, although only 1.84% of them had confirmed bacterial infection, in which the most frequently prescribed antibiotics were amoxicillin + clavulanic acid, ceftriaxone, and doxycycline. 16 A study conducted in Malaysia showed that the use of antibiotics was 17.1% of cases, with two or more antibiotics being given in 5.5% of cases, with the most frequently given antibiotics were amoxicillin/clavulanic acid (37.8%), followed by ceftriaxone (12.3%), piperacillin/tazobactam (13.3%), azithromycin (8.3%), and meropenem (7.0%).…”

“…5 A retrospective study reported that cephalosporins, macrolides, quinolones, and ampicillin/clavulanic acid were the most prescribed antibiotics among hospitalized COVID-19 patients. [6][7][8][9][10] A study showed the pattern of antibiotic use in patients with COVID-19 and bacterial infections, highlighting the urgent need for further research to assess the effect of COVID-19 on antimicrobial resistance at both the patient and population levels. 10 Thus, we conducted a study aimed to describe the prevalence of antibiotic use in hospitalized COVID-19 patients in hospitalized patients in secondary healthcare hospitals in Kosovo.…”

Diagnostic and antibiotic use practices among COVID-19 and non-COVID-19 patients in the Indonesian National Referral Hospital

“…studies reported an overuse of antibiotics amongst COVID-19 hospitalized patients. There might be a false belief of antibiotic use as medical prophylaxis to reduce secondary bacterial infections [36][37][38][39]. These highlight the need to improve clinician adherence to the well-developed evidence-based antibiotic guidelines [38,39].…”